Lateral Epicondylitis

Lateral epicondylitis is a persistent aggravating clinical entity. It is most common between 35 and 60 years of age, rarely occurs before age 20, and is seven times more common than medial epicondylitis. Causative physical factors include forceful gripping, throwing, lifting with palms up, forceful wrist extension, and repeated blunt trauma to the elbow. Poor overall conditioning may predispose to lateral epicondylitis due to fatigue of the shoulders and increased use of the wrists. The standard treatment has been use of the forearm strap, physical therapy (PT), and corticosteroid injection if inadequate response. Recent studies have indicated that steroid injections offer short-term pain relief but no greater or even poorer long-term results than PT. Surgery is reserved for severe cases, resulting in limitation of activities of daily living persisting at least 6 months and recalcitrant to nonoperative treatment. Long-term results are not encouraging, as 5% are resistant to conservative treatment, 40% observe prolonged minor discomfort, and 25% recur within 5 years (48,49).

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